Provider Demographics
NPI:1609895614
Name:BLANKENHORN, JAMES CALVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CALVIN
Last Name:BLANKENHORN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 TREXLER AVE
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9707
Mailing Address - Country:US
Mailing Address - Phone:610-683-6677
Mailing Address - Fax:610-926-4556
Practice Address - Street 1:162 TREXLER AVE
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9707
Practice Address - Country:US
Practice Address - Phone:610-683-6677
Practice Address - Fax:610-926-4556
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-021204-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice